By Samuel S. Epstein, M.D.,
Chairman of the Cancer Prevention Coalition
Based on an industry-funded multi-university
trial on 282 pre-teen children treated with Ritalin for attention
deficit/hyperactivity disorders (ADHD), just published in
Pediatrics, the American Academy of Pediatrics has endorsed
the use of the drug.
However, the Academy ignores clear evidence
of the drug's cancer risks
of which parents, teachers and school nurses, besides most
pediatricians and psychiatrists, still remain uninformed and
unaware.
Some 40 years after the drug was first marketed by Ciba Geigy,
carcinogenicity tests were conducted at the taxpayers expense
by the National Toxicology Program, the results of which were
published in 1995. Adult mice were fed Ritalin over a two-year
period at dosages close to those prescribed to children.
The mice developed a statistically
significant incidence of liver abnormalities and tumors,
including highly aggressive rare cancers known as hepatoblastomas.
These findings are particularly disturbing as the tests were
conducted on adult, rather than young mice which would be
expected to be much more sensitive to carcinogenic effects.
The National Toxicology Program concluded
that Ritalin is a "possible human carcinogen," and
recommended the need for further research. While still insisting
that the drug is safe, the Food and Drug Administration admitted
that these findings signal "carcinogenic potential,"
and required a statement to this effect in the drug's package
insert. However, these inserts are not seen by parents or
nurses.
The Physicians' Desk Reference admits evidence on the carcinogenicity
of Ritalin, now manufactured by Novartis, qualified by the
statement that "the significance of these results is
unknown," apparently not recognizing that this is more
alarming than reassuring. Apart from cancer risks, there is
also suggestive evidence that Ritalin induces genetic damage
in blood cells of Ritalin-treated children.
Concerns on Ritalin's cancer risk are more acute in view of
the millions of children
treated annually with the drug and the escalating
incidence of childhood cancer, by some 35% over the last few
decades, quite apart from delayed risks of cancer in adult
life. These risks are compounded by the availability of alternative
safe and effective procedures, notably behavior modification
and biofeedback.
There is no justification for prescribing Ritalin, even by
highly qualified pediatricians and psychiatrists, unless parents
have been explicitly informed of the drug's cancer risks.
Otherwise, prescribing Ritalin constitutes unarguable medical
malpractice.
Cancer
Prevention Coalition October 4, 2001
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